No. 101 



Health, Education, Recreation 



WHAT AMERICAN CITIES ARE DOING 

FOR THE HEALTH OF SCHOOL 

CHILDREN 

REPORT COVERING CONDITIONS IN 1038 CITIES 



RS 
•F- 



Department of Child Hygiene 

Russell Sage Foundation 

400 Metropolitan Tower, New York City 



Price 15 Cents 



4-31-11-40 



fe., . 
$EP30l»U 



I 






^\^ 
^ 



^ a^ 



What American Cities Are Doing 

for the Health of School 

Children 

PART I 

Medical Inspection 



What American Cities are Doing for the 
Health of School Children 



PART I— MEDICAL INSPECTION 

A little more than sixteen years ago, in 1894, and as a result 
of some serious epidemics among school children, the city of 

Boston divided its public schools into fifty 
Beginnings districts and appointed fifty doctors to begin 
in Boston medical inspection in them. The Department 

of Child Hygiene of the Russell Sage Founda- 
tion has just completed an investigation to find out what pro- 
gress has been made in. this field in the sixteen years that have 
elapsed since this beginning. 

Medical inspection is an extension of the activities of the 
school in which the educator and the physician join hands to 

insure for each child such conditions of health 
Prevention and vitality as will best enable him to take full 
of Disease advantage of the free education offered by the 
and Gonser- state. Its object is to better health conditions 
vation of among school children, safeguard them from 

Vitality disease, and render them healthier, happier, and 

more vigorous. It is founded on a recognition 
of the intimate relationship between the physical and mental 
conditions of the children, and the consequent dependence of 
education on health conditions. 

There are in this country some 1285 cities having organized 

systems of graded public schools under super- 
Investiga- intendents. The investigation covers these cities 

tion includes and returns have been received from 1038 or 
90 per cent nearly 90 per cent of them. For the purposes 
of American of tabulating results, the several states of the 
Cities Union have been divided into five groups, 

following the order adopted by the United States 
Census. These groups with the states comprising them are as 
follow^s : 

3 



Maine 

New Hampshire 

Vermont 



North Atlantic Division 

Massachusetts New York 

Rhode Island New Jersey 

Connecticut Pennsylvania 



South Atlantic Division 

Delaware Virginia South Carolina 

Maryland West Virginia Georgia 

District of Columbia North Carolina Florida 



Kentucky 
Tennessee 
Alabama 



Ohio 

Indiana 

Illinois 

Michigan 

Montana 

Wyoming 
Colorado 
New Mexico 



South Central Division 

Mississippi Arkansas 



Louisiana 
Texas 



Oklahoma 



North Central Division 

Wisconsin North Dakota 

Minnesota South Dakota 

Iowa Nebraska 

Missouri Kansas 

Western Division 

Arizona Washington 



Utah 

Nevada 

Idaho 



Oregon 
California 



Forty-three per cent of the cities reporting have regular 
organized systems of medical inspection in 
their public schools. The number of cities 
reporting, the number having systems of medi- 
cal inspection, and the per cent having such 
systems in each state group are shown in the 
following table: 



43 per cent 
of the cities 
have Medi- 
cal Inspec- 
tion 



Cities Having Medical Inspection in 1911 



Division 
North Atlantic 
South Atlantic 
South Central 
North Central 
Western . 

United States. 



, 




Per Cent 




Cities Having 


Having 


Cities 


Medical 


Medical 


Reporting 


Inspection 


Inspection 


411 


236 


58 


74 


23 


31 


lOI 


35 


35 


382 


109 


29 


70 


40 


57 



1038 



443 



43 



The percentage figures in the final column show that medical 
inspection has made the best progress in the North Atlantic 
and Western Divisions, where about sixty per cent of the cities 
have taken up the new work. It has made very nearly equal pro- 
gress in the two Southern Divisions, where the percentages 
are 31 and 35, and the poorest showing is made by the North 
Central Division, where only 29 per cent of the cities have medical 
inspection systems. 



It has been stated that the first system of medical inspection 
was inaugurated by Boston in the year 1894, and historically 
this statement seems to be correct. Nevertheless one city 
claims to have been doing enough work for the health of school 
children to warrant it in reporting that it had a system of medi- 
cal inspection in the year 1890. Ten years later, in 1900, eleven 

cities had such systems, and in the five following 
Great In- years the increase had brought the total number 

crease in Past up to fifty-five. The most rapid development 
Six Years of medical inspection has come in the past six 

years, during which the number has increased 
from fifty-five to more than four hundred. Out of the four 
hundred forty-three cities reporting systems of medical inspection, 
only four hundred and eleven state the year in which work was 
first begun. From the records of these cities a table has been 
compiled showing the total number of cities having medical 
inspection systems in each year since the first city began. The 
facts follow : 



Number of Cities Having Systems of Medical Inspection 
IN Each Year From 1890 to 191 i 

Number of Cities 
I 
4 



Year 
1890 
1894 
1897 
1898 
1899 
1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
1908 
1909 
1910 
I91I 



9 
II 

17 

23 

28 

37 

55 

n 

III 

167 

263 

400 

411 



The reason for the comparatively slight increase in the year 
1 911 is that the data were gathered in the early spring and include 
in most cases only one or two months of the year. 

The chart on page 6 represents graphically the number of 
cities having medical inspection each year since 1890, and shows 
how the growth of the movement has been at first slow and 
gradual and in the last few years increasingly rapid. 



It 



09 



08 



07 



06 



05 



90 94 97 9^ 99 00 



01 ^^ 



04 



I 4 5 8 9 II 17 23 2S 37 55 77 III 167 263 400 4!! 

CITIES HAVING SYSTEMS OF MEDICAL INSPECTION FROM 1890 TO 1911 

There are two standard types of administration, that under 
the Board of Health and that under the Board of Education. 
In the early days of medical inspection, practi- 
cally all the systems were administered by 
local Boards of Health, but in recent years 
the tide has turned the other way until at the 
present time about one-quarter of the cities 
have systems under the Board of Health, and 
in the remaining three-quarters the Board of 
Education is the controlling body The facts 
for the different divisions are shown in the following table: — 



Administra- 
tion by 
Boards of 
Health and 
Boards of 
Education 



The Administration of Medical Inspection Among 443 

Cities Reporting 





By Boards 


By Boards 


Division 


OF Health 


OF Education 


North Atlantic . • 


• . 58 


178 


South Atlantic 


7 


16 


South Central 


12 


23 


North Central 


21 


88 


Western . 


8 


32 


United States 


106 


337 



Three Kinds 
of Medical 
Inspection 
Work 



Medical inspection as now carried on in American schools 
may be divided into three classes of work. The 
first is inspection for the detection of cases of 
contagious diseases. The second consists of 
examinations conducted by the teachers them- 
selves to detect defective vision and hearing. 
The third comprises complete physical exami- 
nations of the pupils to detect physical defects and organic 
diseases. 

Where there is any sort of medical inspection it is nearly 
invariably true that the inspection for the detection of contagious 
diseases is included as one of the most important 
items. Indeed there are many cities in which 
this is the only work carried on. Its object is 
primarily the protection of the community, and 
because of this is often conducted by physicians 
of the Board of Health. In most cities the in- 
spectors call daily at the schools to which they 
are assigned and examine such pupils as are referred to them by 
the teachers and principals. These pupils include all who have 
returned to school after having been absent on account of illness 
or from unknown causes as well as those who are in school and 
suspected of suffering from some infectious or contagious ail- 
ment. 

Among the four hundred forty-three cities having systems of 
medical inspection examinations for the detection of contagious 
diseases are made in four hundred and five. The number and 
per cent of cities doing this work in each of the Divisions are as 
follows : — 



Inspection 
for the De- 
tection of 
Contagious 
Diseases 



Inspection for the Detection of Contagious 

Diseases 



Division 
North Atlantic 
South Atlantic 
South Central 
North Central 
Western . 



United States 







Per Cent br 


Number 


OF 


Total 


Number of 


Cities Reporting 


Cities Reporting 


. 224 






55 


23 






31 


• 34 






34 


• 93 






24 


31 






44 



405 



39 



In no fewer than 552 cities vision and hearing tests are con- 
ducted by teachers, and in addition the work is carried on by 



8 



Vision and 
Hearing 
Tests by 
Teachers 



doctors in 258 cities. These figures include 
some duplicates, for there are some cities in 
which the tests of vision and hearing are applied 
by the doctors in some cases and by the teachers 
in others. Even allowing for a considerable 
amount of such duplication it is evident that 
this sort of work is carried on in many more cities than those 
reported as having organized systems of medical inspection. 

The policy of legislators and school administrators in arrang- 
ing to have tests for sight and hearing conducted by school 
teachers rather than by specialists has occasioned many expres- 
sions of surprise and no little criticism. This policy, however, 
has reached its present wide development on the recommenda- 
tions of specialists themselves, w^ho deem that such tests are 
wholly within the capacity of the teacher. It is their opinion 
that children are subjected to less nervous strain when tested 
by their teachers than when tested by strangers, and therefore 
exhibit themselves in a more natural way. It is always the 
intention, however, wherever this policy is followed to have 
scientific examinations made by specialists in cases where de- 
fects are apparently revealed by the teachers' tests. For this 
purpose there are furnished blanks on which the teachers notify 
the parents of apparent defects and advise consulting a spec- 
ialist. 

The detailed facts as to tests by doctors and teachers are as 
follows : — 

Vision and Hearing Tests Conducted by Doctors and 

BY Teachers 

:0RS Tests by Teachers 

261 
29 

43 
182 

552 

Municipal and educational authorities in America have very 
generally realized that the theory on which 
physical examinations are conducted rests on 
a different foundation from that underlying 
medical inspection for contagious diseases. The 
latter is primarily a protective measure and 
looks mainly to the present safeguarding of 



Division 


Tests by I 


North Atlantic . 


. 125 


South Atlantic 


12 


South Central 


23 


North Central 


73 


Western . 


. 25 


United States 


. . . 258 



Examina- 
tions to 
detect Phys- 
ical Defects 



the community. The former aims at securing the physical 
soundness and strength of the individual and looks far into the 
future. 

It has been brought into being by successive results of a long 
series of studies which have shown that there are many physical 
defects which are common among children and have an important 
bearing on their present health and future development which 
may be easily remedied or modified if they are discovered early 
enough. Although 443 cities report systems of medical inspec- 
tion, in only 214, or a little less than half, of them does the work 
include a complete physical examination conducted by doctors. 
Moreover, the cities attempting physical examinations are mostly 
in the North Atlantic Division, where the work is oldest and is 
most highly developed. 

In the table which follows figures are presented showing the 
number of cities in each Division including in their medical 
inspection systems full physical examinations for the detection 
of defects: — 

Number of Cities Having Examinations for the Detection 

OF Physical Defects 



Division 
North Atlantic 
South Atlantic 
South Central 
North Central 
Western 

United States 



Number of Cities 

135 
10 
12 
38 
19 

214 



There are 141 5 school doctors employed in the work of medical 

inspection in the cities reporting. More than 

School half of these are in the North Atlantic States, 

Doctors and more than half of the remainder in the North 

Central States. Their distribution in the several 

divisions is as follows: — 

Number of School Doctors Employed in Medical 

Inspection 



Division 
North Atlantic. 
South Atlantic 
South Central 
North Central . 
Western . 



Number of Doctors 

852 
48 

41 

417 
57 



United States 141 5 

The school nurse is now considered to be one of the most 



lO 

necessary adjuncts of the better developed systems of medical 

inspection. The total number employed in 

The School American cities at the beginning of the year 

Nurse 191 1 is 415, of whom 375, or 90 per cent, are in 

the North Atlantic and North Central States. 

The first regular employment of trained nurses in connection 
with the work of medical inspection was begun in New York 
City in December 1902, when a corps of nurses was established 
at a salary of seventy-five dollars each per month. Since that 
time experience has proved, especially in the largest cities, that 
the employment of competent school nurses is almost a neces- 
sity. 

The nurses are especially valuable in reducing the number 
of exclusions of children from school on account of minor ill- 
nesses. Many of these when properly treated by the nurse in 
school do not prevent the regular attendance of the child. The 
trained nurse greatly enhances the success of the work of the 
school physician in improving the health of the school children. 
She aids the school teacher in detecting the first signs of approach- 
ing illness. She sees to it that all excluded cases are placed under 
treatment as soon as may be, so that there is the least possible 
loss of time from school and interference with education. She 
treats those cases which would for various reasons receive no 
attention at their homes. She assists the school physician in 
the clerical work of recording the results of the physical ex- 
aminations which he conducts. 

In many cases it is also found feasible to emplo}^ the nurses 
during the summer months, when there is no school, in work 
directed to the lessening of the great mortality rate among 
infants from summer diarrhoea, due mainly to improper care 
and feeding. Again, she aids materially in the anti-tubercu- 
losis campaign. 

About one-quarter of the cities having any sort of medical 
inspection employ school nurses, and the number is increasing 
rapidly. In quite a large number of cities where there are no 

school doctors nurses are employed. 
The Nurse To sum up the case for the school nurse: she 

the Link is the instructor of parents, pupils, teachers and 

between all members of the family in the principles and 

School and practices of hygiene. She is a most efficient 
Home link between the school and the home. 



II 



Increasing attention is being given to the inspection of chil- 
dren's teeth in American schools and the work is being more 
and more commonly carried on as a branch 
Dental In- of medical inspection in a semi-independent 
spection way. In a number of the larger cities the local 

dental associations have established clinics 
at which school children are given treatment either gratis or 
nearly so. In most of these cases the services of the dentists 
are given without remuneration, but in a few cities dentists 
have been added as regularly paid members of the corps of 
medical inspectors. Sixty-nine cities have dental inspection 
conducted by dentists, and of these fifty-four, or 79 per cent, 
are in the North Atlantic and North Central States. 

Professor William Osier is credited with saying with regard 
to the work of medical inspection in England: '* If we are to have 
school inspection, let us have good men to do 
Salaries of the work and let us pay them well. It will 
Doctors demand a special training and a careful tech- 

nique." It is certainly to be regretted that this 
point of view has not been more generally taken in America. 
In this country the financial remuneration of school physicians 
and school nurses is almost invariably inadequate. The salaries 
paid range from nothing to $4,000 per annum. In many 
localities the local medical association conducts medical inspec- 
tion for a year or two without cost to the city in order to dem- 
onstrate its value. This results in the tabulated returns showing 
that in a considerable number of cities the doctors and nurses 
receive no pay at all for their services. It may also be a factor 
in bringing about the extremely low salaries that are received 
after regular payment is given. 

The following table is made up from the study of conditions 
in 1038 cities and shows the number of localities in which the 
salaries of doctors and nurses fall within the salary limits named 
in each group. That is to say, the first line shows that there are 
75 cities in which the doctors donate their services and 21 in 
which the school nurses do the same. The second line indicates 
that there are 47 cities in which the salaries paid to the doctors 
are between $1.00 and $100 per annum. 



12 



Annual Salaries of Doctors and Nurses in All Cities 

Reporting 









Number of Cities 


Where Doctors 


Receive Salary 


Indicated 


No salary 75 


$1-100 








47 


$101-200 . 








50 


$201-300 . 








44 


$301-400 . 








25 


$401-500 . 








24 


$501-600 . 








18 


$601-700 . 








2 


$701-800 . 








12 


$801-900 . 








6 


$901-1000 








13 


$1001-1500 








18 


$1501-2500 








7 


$3500-4000 








3 


Fees according 


to se 


rvice 




19 



Number of Cities 

Where Nurses 

Receive Salary 

Indicated 

21 



I 
21 

17 

24 

15 
2 
2 



The table shows that there are more cities paying their school 
physicians at the rate of between $100 and $200 per year than 
there are paying salaries of any other amount. On the other 
hand, the average salary is somewhat higher than this. If 
computed on the basis of the table without taking into account 
the number of doctors employed in each individual city, the 
average salary would fall within the group receiving from $201 
to $300 per annum. 

In a similar way the second column of the table shows that 
there are more cities paying their school nurses from $701 to 

$800 per annum than there are paying any other 
Salaries of salary, but the average salary would be about 
Nurses $700 per year. Of course the sum of $200 

per annum is given in return for only a part 
of the school doctor's time. Nevertheless, it has come to be 
regarded as a somewhat standard rate of remuneration for 
school physicians all over America. There are cases where 
so little work is required that this amount may be considered 
adequate, but undoubtedly in most cases it represents an undue 
degree of sacrifice on the part of the school physician. 

The per capita cost of medical inspection for salaries alone 
ranges from about one-half of one cent for vision and hearing 

examinations conducted by teachers to about 
Per Capita $1.25 for complete physical examinations in 
Cost a few localities. These extremes, however, do 

not at all represent average conditions. In 



13 

general the per capita cost of medical inspection in America 
ranges from ten to fifty cents per annum. It seems to be a 
fair generalization to say that medical inspection for the detec- 
tion of contagious diseases can be adequately performed at 
an annual cost of about fifteen cents per capita, while physical 
examinations similarly performed and including the inspection 
for the detection of communicable diseases cost about fifty cents. 
Physical examinations for the detection of non-contagious 
physical defects can be made by an experienced school physician 
in about twelve to fifteen minutes per child. 
Time re- Vision and hearing tests alone demand from 

quired for three to five minutes per child. Systems of 
Physical Ex- medical inspection which include careful phys- 
aminations ical examination of all children cost the most 
and are by far the most valuable. From a 
social and economic point of view they are by far the cheapest 
in the better sense of the word, as they are the most far-reach- 
ing, both in their immediate and indirect results. Permanent 
efficiency requires skilled workers, careful administration and 
adequate remuneration. 



PART II 

Hygiene of the School Room 



PART II— HYGIENE OF THE SCHOOL ROOM 



The gathering of the salient facts regarding the present status 
of medical inspection was not the sole object of the present 
investigation. A second and related purpose was to discover 
what the different cities are doing in the administration of the 
health interests of their school children in such matters as recesses, 
the cleanliness of floors and windows, precautions as to drink- 
ing cups and instruction in such matters as the prevention of 
tuberculosis and the giving of first aid in emergencies. 

It is generally taken as a matter of course that the outdoor 
recess is part of the regular program in all elementary grades, 
and in both sessions of the day school. More- 
Outdoor over, such is the case in large sections of the 
Recesses country, but the data gathered show that it 
is far from being true in the North Atlantic 
States, and that in the other divisions there are cities where 
the children are not given outdoor recesses. The figures showing 
the number of cities having outdoor recesses in their elementary 
classes, and the per cent of such cities, are given in the following 
table : — 

Number and Per Cent of Cities Having Outdoor Re- 
cesses IN All Elementary Grades 

Cities Having Outdoor Per Cent Having 
Reporting Recess Recess 



Division 
North Atlantic 
South Atlantic 
South Central 
North Central 
Western . 

United States. 



411 

74 

lOI 

382 
70 



1038 



346 

72 

100 

363 
66 

947 



84 
97 
99 
95 
94 

91 



Another subject for investigation was the extent to which 
individual drinking cups and sanitary fountains 
Individual are in use in the different cities. As the informa- 
Drinking tion was gathered, the city recorded as having 

Cups and sanitary drinking fountains or individual cups 

Sanitary has at least made a beginning in these directions. 

Fountains The number of cities in each division having 
schools supplied with either or both is shown 
in the following table: — 

2 17 



Number of Cities Where the Schools are Supplied with 

Sanitary Drinking Fountains and Individual 

Drinking Cups 





Number of 


Cities 


Number of Cities 




Supplying Individual 


Supplying Sanitary 


Division 


Cups 




Fountains 


North Atlantic . 


. 97 




316 


South Atlantic 


20 




54 


South Central . 


. . 38 




67 


North Central . 


97 




286 


Western . 


12 




62 


United States . 


. 264 




785 



The figures here given do not indicate what proportion of 
the schools of each city has these appUances. They merely 
indicate that at least a beginning has been made. The figures 
show that in twenty-five per cent of the cities individual drink- 
ing cups are in use, and in seventy-five per cent the schools 
have sanitary drinking fountains. These figures do not mean 
that all cities are supplied with either individual cups or sani- 
tary fountains, for the data include many duplicates. A 
considerable number of cities have schools equipped with both 
individual cups and sanitary fountains, and, on the other hand, 
some cities have not introduced either one or the other. 

The deadly feather duster is rapidly being banished from 
our public schools. Among the 1038 cities 
from which reports were received, 643, or over 
sixty per cent, are using moist cloths for dust- 
ing purposes, and 894, or close to ninety per 
cent, are using dust-absorbing compounds for 
sweeping. 
In the forefront of progress with respect to the adaptation 
of modern sanitary appliances are eighty-seven cities that are 
cleaning their school rooms by means of vacuum cleaners. 
Thirty-three of these cities are in the North Atlantic States, 
and thirty-seven in the South Central ones. These most en- 
couraging signs of progress with respect to the cleansing of 
school rooms indicate that the day is not far distant when our 
schools will be as clean as hospitals, and for the same reasons. 

But a slight knowledge of housekeeping is necessary to make 
one realize that the appliances used for cleaning are not of such 
importance as the frequency with which they 
are employed. Having this in mind, we have 
gathered the facts as to the frequency with 
which the school room floors are washed and 
swept, and the windows washed, in the public 



Modern Me- 
thods of 
Dusting and 
Sweeping 



Frequency 
of Glean- 
ing 



19 



schools of these 1038 cities. The facts as reported are shown 
in the following table : — 

Number of Cities in Which the School Room Floors are 

Washed and Swept and the School Room Windows 

Washed with Frequencies Indicated 



Frequency 
Daily. 
Once in 2 
Once in 3 
Once in 4 
Weekly 
Once in 2 
Once in 3 
Monthly 
Once in 2 
Once in 3 
Once in 5 
Once a year 
As needed 
Never 
Not reporting 

Total 



days 
days 
days 

weeks 
weeks 



months 
months 
months 



Cities Where 

Floors are 

Washed with 

Frequency 

Indicated 

II 
6 
I 

48 

44 
6 

193 

71 
185 
148 

82 

91 

51 

91 

1038 



Cities Where 


Cities Where 


Floors are 


Windows are 


Swept with 


Washed with 


Frequency 


Frequency 


Indicated 


Indicated 


813 




70 




106 




2 




6 


31 


2 


12 




5 


2 


171 


I 


113 


. . 


191 




156 




45 


13 


189 




7 


23 


116 



1038 



1038 



The figures are as illuminating as they are unique. Probably 
these details of municipal housekeeping have not before been 

gathered. They seem to indicate that the 
Washing of most common practice sanctions the washing 
Floors of class room floors, either once a month or 

once in three months, although it is by no 
means rare to find cities in which they are washed once in five 
months or never washed at all. 

In the great majority of the cities school room floors are 

swept once a day, but nevertheless there remains 
Sweeping of a balance of over two hundred cities in which 
Floors they are swept less frequently. Six cities 

report that they are swept only once a week 
and two cities once a month. 

More cities seem to wash their class room windows once 

in three months than on any other regular 
Window schedule. On the other hand, thirty-one cities 

Washing report washing them once a week, and seven 

cities that they never wash them at all. 
Adjustable desks which can be fitted to the size of the pupils 
are more common proportionately in the North Atlantic States 



20 



than elsewhere. In the country as a whole^ 
Adjustable they are in use in less than half of the cities. 
Desks They are more common in the North than in the 

South. The figures showing the number of cities 
where they are in use and the per cent which these are of the 
entire number reporting are as follows: — 

Number of Cities Using Adjustable Desks in Their 

Schools 





Number Having 


Per 


Cent Having 


Division 


Adjustable Desks 


Adjustable Desks 


North Atlantic 


• 257 




63 


South Atlantic 


15 




20 


South Central 


25 




25 


North Central 


• 105 




28 


Western . 


26 




37 


United States. 


. 428 




41 



Just as highly perfected methods for cleaning are not effi- 
cacious unless they are frequently used, so adjustable desks 
are not beneficial unless they are frequently adjusted to the 
size of the children using them. These 428 cities having 
adjustable desks report that they are adjusted as follows: — 

Cities Adjusting Desks at Each Interval Named 

Interval Number of Cities 
Daily i 



Once a week 
Once a month . 
Once in 3 months 
Once in 5 months 
Once in 6 months 
Once a year 
As needed . 
Never . 

Total . 



I 

2 

22 

15 

3 

13 

370 

I 

428 



Besides the indirect benefit and training which the children 
receive from having their class rooms hygienically administered 
there remains the question of the direct in- 
struction they receive in theoretical and applied 
hygiene. To discover something of what is 
being done in this field, facts have been gathered 
showing the number of cities having regular 
courses for teaching the children about the 
effects of the use of alcohol and tobacco, for 
training them in the avoidance and cure of 
tuberculosis, and in giving them instruction about first aid to 
the injured. 

The figures show that 95 per cent of the cities teach their 



Instruction 
in Alcohol, 
Tobacco, 
Tubercu- 
losis and 
First Aid 



21 



children the effects of alcohol and tobacco; 63 per cent have 
special courses on the prevention and cure of tuberculosis; and 
57 per cent give lessons in first aid. The figures showing the 
number of cities doing each kind of work in each of the five 
divisions follow: — 



Division 
North Atlantic 
South Atlantic 
South Central 
North Central 
Western 

United States 



School Hy- 
giene means 
Economy 
not Expense 



Cities Giving Instruction in Alcohol and Tobacco, 
Tuberculosis, and First Aid 

Alcohol and Tobacco Tuberculosis First Aid 

388 264 223 

65 44 32 

92 66 59 

374 238 238 

63 37 40 

982 649 592 

The facts that have been so rapidly reviewed show that 
communities over the entire country are seeing the whole matter 
of the health of school children in a new light. 
Gradually they are beginning to ask, not whe- 
ther they can afford to take steps to safeguard 
in the schools the welfare of their children, 
but whether they can afford not to take such 
steps. The movement as a whole constitutes 
both a sign and a result of the gradual awakening which has 
developed in a wave of interest in matters pertaining to the 
health of school children that is now sweeping over the civilized 
world. 

We are beginning to realize that the public schools are a public 
trust. When the parents deliver a child to their care, they 
have a right to expect that the child, under 
the supervision of the school authorities, will 
be safe from harm, and will be handed back 
to them in at least as good condition as he was 
at first. Individual efficiency rests not alone 
on education or intelligence, but is equally depen- 
dent on physical health and vigor. Hence, if the 
State may enforce training in intelligence, it may also demand 
training to secure physical soundness and capacity. Much time 
will elapse before there will^ be brought to bear in all schools 
measures now so successfully pursued in some for preserving 
and developing the physical soundness of rising generations. 
Nevertheless, the movement is so intimately related to the 
future welfare of our country, and is being pushed forward with 
so great energy and earnestness that it is destined to be success- 
ful and permanent. 



Physical 
Soundness 
the Basis of 
Social Pro- 
gress 



22 



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24 



MEDICAL INSPECTION IN CITY PUBLIC SCHOOL 

SYSTEMS— 191 1 



Alabama 

1 Armiston 

2 Birmingham . . 

3 Florence 

4 Gadsden 

5 Mobile 

6 New Decatur . 

7 Opelika 

8 Selma 

9 Tuscaloosa. . . . 

Total 

Arizona 

1 Bisbee 

2 Douglas 

3 Phoenix 

4 Prescott 

Total 

Arkansas 

1 Fayetteville . . . 

2 Fort Smith . . . . 

3 Helena 

4 Hot Springs . . . 

5 Jonesboro 

6 Little Rock . . . 

7 Paragould .... 

8 Pine Bluflf 

9 Texarkana .... 

Total 

California 

1 Alameda 

2 Berkeley 

3 Fresno 

4 Los Angeles . . . 

5 Napa 

6 Oakland 

7 Pasadena 

8 Pomona 

9 San Bernardino 

10 San Diego. . . . 

1 1 San Francisco . 

12 San Jose 

13 San Rafael .... 

14 Santa Ana .... 

15 Santa Barbara . 

16 Santa Clara . . . 

17 Santa (Truz. . . . 

18 Santa Rosa. . . , 

19 Watsonville . . . 

Total 



12,794 
132,68s 

6,689 
10,557 
SI. 521 

6,118 

4.734 
13.649 

8,407 



9.019 

6,437 

11,134 

5.092 



4.471 
23.975 

8,772 
14.434 

7.123 
45.941 

5.248 
15.102 

S.655 



23 
40 
24 

319 
5 

150 
30 
10 
12 
39 

416 

28 

5 

8 

II 

4 

II 

7 

4 



.383 
.434 
819 
.198 
.791 
.174 
,291 
.207 
,779 
.578 
,912 
,946 
.934 
.429 
,659 
.348 
,146 
.817 
.446 



< 
Q O 

< 



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^ S 
^'^ 

< 



1910 
1909 

1909 



1910 
1909 



1905 



1909 



1910 
1909 
1910 
1907 

1909 
1908 
1909 

1910 
1907 
1908 

1910 

1909 



13 



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14 



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25 



Colorado 

1 Boulder 

2 Canon City 

3 Colorado Springs . . , 

4 Cripple Creek , 

5 Denver 

6 Florence 

7 Grand Junction . . . . 

8 Leadville , 

9 Pueblo , 

District No. 20 

10 Salida , 

1 1 Trinidad 

12 Victor 

Total 

Connecticut 

1 Ansonia 

2 Bridgeport 

3 Bristol 

4 Danbury 

5 Derby 

6 Hartford 

7 Manchester 

8 Meriden 

9 Middletown 

10 Naugatuck 

11 New Britain 

12 New Haven 

13 New London 

14 Norwalk 

1 5 Norwich : 

West Chelsea Dist 

16 Putman 

17 Rockville 

18 South Manchester. . 

19 South Norwalk 

20 Stamford 

2 1 Torrington 

22 Wallingford 

23 Waterbury 

24 West Haven 

25 Winsted 

Total 

Delaware 

I Wilmington 

Total 

Florida 

1 Jacksonville 

2 Lake City 

3 Live Oak 

4 Ocala 

5 St. Augustine 

6 Tampa 

Total 



9,539 
6,206 
29,078 
6,206 
213,381 
2,712 

7,754 
7,508 

44,395 

4,425 

10,204 

3,162 



15,152 

102,054 

9,527 

20,234 

8,991 

98,915 

13,641 

27,265 

11,851 

12,722 

43,916 

133,605 

19,659 

6,954 

20,367 

6,637 
7,977 

8,968 
25,138 
15,483 

8,690 
73,141 

8,543 

7.754 



87,411 



57,699 
5,032 
3,450 
4.370 
5,494 

38,524 



Q O 

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15 



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1909 
1910 



1909 
1909 



1909 
1909 



1910 



1909 



1909 
1910 



1908 
1898 

1910 
1910 
1902 
1910 
1 901 
1908 



1905 

1905 
1910 

1910 



1910 



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26 



Georgia 

1 Athens 

2 Atlanta 

3 Augusta 

4 Columbus 

5 Cordele 

6 Dalton 

7 Dublin 

8 Elberton 

9 Gainesville 

10 Griffin 

11 Newnan 

12 Rome 

13 Thomasville. . . . 

Total 

Idaho 

1 Boise 

2 Pocatello 

3 Wallace 

Total 

Illinois 

1 Alton 

2 Aurora: 

East Side . . . . 

3 Belleville 

4 Belvidere: 

North Side 

South Side . . . . 

5 Blue Island 

6 Cairo 

7 Canton 

8 Centralia 

9 Champaign 

10 Charleston 

11 Chicago 

12 Chicago Heights . 

13 Clinton 

14 Danville 

15 Decatur 

16 De Kalb 

17 East St. Louis. . . 

18 Elgin 

19 Evanston: 

District No. 75 
District No. 76 

20 Forest Park 

21 Freeport 

22 Galesburg 

23 Harvey 

24 Hoopestown . . . , 

25 Jacksonville 

26 Joliet 

27 Kankakee 

28 Kewanee 

29 Lincoln 

30 Litchfield 

31 Macomb 

32 Matoon 

33 Maywood 

34 Moline 

35 Monmouth 

36 Murphysboro. . . 

37 Normal 

38 Ottawa 



14.913 

154.839 

41,040 

20,554 
5.883 
5,324 
5,795 
6,483 
5,925 
7,478 
5.548 

12,099 
6,727 



17,358 
9,110 
3,000 



17,528 
29,807 

21,122 
7,253 



8,043 
14.548 
10,453 

9,680 
12,421 

5.884 

2,185,283 

14.525 

5.165 
27,871 
31.140 

8,102 
58,547 
25.976 
24,978 



6,594 

17.567 

22,089 

7.227 

4.698 

15.326 

34.670 

13,986 

9,307 

10,892 

5,971 

5,774 

11,456 

8,033 

24,199 

9.128 

7.485 

4,024 

9.535 



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* 1910 

* 11909 

* [1910 

* '1910 

* 1908 



1910 
1909 
1907 

1910 



1911 



1910 



1910 
1910 



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100 40 



27 



Illinois (Continued) 

39 Pana 

40 Pekin 

41 Peoria 

42 Peru 

43 Pontiac 

44 Princeton 

45 Rockford 

46 Rock Island . . . 

47 South Dixon. . . 

48 Springfield 

49 Sterling: 

District No. 8 

50 Sycamore 

51 Taylorville: 

East Side. . . . 
West Side . . . . 

52 Urbana 

53 Waukegan 

Total 

Indiana 

1 Alexandria 

2 Anderson 

3 Bedford 

4 Bloomington. . . 

5 Bluffton 

6 Brazil 

7 Columbus 

8 Connersville . . . 

9 Crawfordsville . 

10 East Chicago . . 

11 Elkhart 

12 Evansville 

13 Fort Wayne . . . 

14 Frankfort 

15 Franklin 

16 Garrett 

17 Gas City 

18 Greenfield 

19 Greensburg. . . . 

20 Hammond 

21 Hartford City . . 

22 Huntington . . . . 

23 Indianapolis. . . 

24 Jeffersonville . . . 

25 Kokomo 

26 Lafayette 

27 Laporte 

28 Lawrenceburg . . 

29 Lebanon 

30 Logansport .... 

31 Madison 

32 Marion 

33 Michigan City . 

34 Mishawaka. . . . 

35 Montpelier. . . . 

36 Muncie 

37 New Albany . . . 

38 Peru 

39 Plymouth 

40 Portland 

41 Princeton 

42 Richmond 

43 Rushville 

44 South Bend . . . . 

45 Terre Haute . . . 

46 Valparaiso 



6,055 

9,897 

66,950 

7,984 

6,090 

4.131 

45,401 

24,335 

5'ii678 

7,467 

3,926 
5,446 



8,24s 
16,069 



5,096 

22,476 

8,716 

8,838 

4,987 

9,340 

8,813 

7,738 

9,371 

19,098 

19,282 

69,647 

63,933 

8,634 

4,502 

4,149 

3,224 

4,448 

5,420 

20,925 

6,187 

10,272 

233,650 

10,412 

17,010 

20,081 

10,525 

3,930 

5,474 

19,050 

6,934 

19,359 

19,027 

11,886 

2,786 

24,005 

20,629 

10,910 

3,838 

5,130 

6,448 

22,324 

4-925 

53,684 

58,157 

6,987 



< 
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I9IO 



1908 



I9II 

1909 



1907 



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1909 



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1908 

1909 



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Indiana (Continued) 

47 Vincennes 

48 Wabash 

49 Warsaw 

50 Washington 

51 Whiting 

Total 

Iowa 

1 Albia 

2 Atlantic 

3 Burlington 

4 Cedar Falls 

5 Cedar Rapids . . . 

6 Cherokee 

7 Clarinda 

8 Clinton 

9 Council Bluffs . . . 
ID Creston 

1 1 Davenport 

12 Decorah 

13 Des Moines 

14 Dubuque 

15 Fairfield 

16 Ft. Dodge 

1 7 Grinnell 

18 Iowa City 

19 Keokuk 

20 Marshalltown . . . 

21 Mason City 

22 Newton 

23 Oelwein 

24 Oskaloosa 

25 Ottumwa 

26 Red Oak 

27 Sioux City 

28 Washington 

29 Waterloo: 

East Side 
West Side 

Total 

Kansas 

1 Arkansas City. . . 

2 Atchison 

3 Cherryvale 

4 Coffeyville 

5 Concordia 

6 Emporia 

7 Fort Scott 

8 Galena 

9 Horton 

10 Hutchinson 

11 Independence. . . 

12 lola 

13 Junction City . . . 

14 Kansas City . . . . 

15 Lawrence 

16 Manhattan 

17 Newton 

1 8 Osawatomie 

19 Ottawa 

20 Pittsburg 

2 1 Rosedale 

22 Salina 

23 Topeka 



14.89s 
8,687 
4.430 
7,858 
6.S87 



4,969 

4.560 
24.324 

5,012 
32,811 

4.884 

3.832 
25.577 
29,292 

6,924 
43.028 

3,592 
86,368 
38,494 

4.970 
15,543 

5.036 
10,091 
14,008 

13,374 

11,230 
4,616 
6,028 
9,466 

22,012 
4,830 

47,828 
4.380 

26,693 



7.508 

16,429 

4.304 

12,687 

4.415 

9.058 

10,463 

6,096 

3,600 

16,364 

10,480 

9.032 

5,598 

82,331 

12,374 
5. 722 
7,862 
4.046 
7,650 

14.755 
5.960 
9,688 

43.684 



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1910 



1904 
1910 



1908 



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1910 



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1908 
1908 



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29 



Kansas (Continued) 

24 Wellington 

25 Wichita 

26 Winfield 

Total 

Kentucky 

1 Ashland 

2 Bellevue 

3 Bowling Green . 

4 Covington 

5 Danville 

6 Dayton 

7 Frankfort 

8 Georgetown .... 

9 Henderson 

ID Hopkinsville . . . 

1 1 Louisville 

12 Madisonville . . . 

13 Maysville 

14 Middlesboro . . . 

15 Newport 

16 Owensboro 

17 Paducah 

18 Paris 

19 Somerset 

Total 

Louisiana 

1 Alexandria 

2 Baton Rouge. . . 

3 Donaldsonville . 

4 Houma 

5 Lake Charles. . . 

6 Monroe 

7 New Orleans . . . 

8 Shreveport 

Total 

Maine 

1 Augusta 

2 Bangor 

3 Bath 

4 Belfast 

5 Biddeford 

6 Brewer 

7 Brunswick 

8 Calais 

9 Eastport 

10 Ellsworth 

11 Houlton 

12 Lewiston 

13 Oldtown 

14 Portland 

15 Rockland 

16 Saco 

17 Sanford 

18 South Portland. 

19 Waterville 

Total 



7,034 

52,450 

6,700 



8,688 

6,683 

9,173 

53,270 

5,420 

6,979 

10,465 

4,533 

11,452 

9,419 

223,928 

4,966 

6,141 

7.305 

30,309 

16,011 

22,760 

5,859 

4,491 



11,213 

14,897 

4,090 

5,024 

11,449 

10,209 

339,075 

28,01s 



13 

24 
9 
4 

17 
5 
5 
6 
4 
3 
5 

26 
6, 

58, 



,211 
,803 
,396 
,618 
,079 
,667 
.341 
,1x6 
,961 
.549 
.845 
.247 
317 
571 
174 
583 
049 
471 
458 



Q O 
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1911 

1909 
1910 

1906 

1908 
1910 



1910 



1907 
1909 



1909 
1909 
1909 



1910 
1908 



1910 

1910 
1910 



p K 

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30 



Maryland 

1 Annapolis 

2 Baltimore 

3 Cumberland .... 

4 Frostburg 

5 Salisbury 

Total 

Massachusetts 

1 Adams 

2 Amesbury 

3 Amherst 

4 Andover 

5 Arlington 

6 Athol 

7 Attleboro 

8 Avon 

9 Barnstable 

10 Belmont 

1 1 Beverly 

12 Boston 

13 Braintree 

14 Brockton 

15 Brookline 

16 Cambridge 

17 Canton 

18 Chelmsford 

19 Chelsea 

20 Chicopee 

21 Clinton 

22 Concord 

23 Danvers 

24 Dedham 

25 Easthampton . . . 

26 Easton 

27 Everett 

28 Fall River 

29 Fitchburg 

30 Framingham . . . . 

31 Franklin 

32 Gardner 

33 Gloucester 

34 Great Barrington 

35 Greenfield 

36 Hingham 

37 Holyoke 

38 Hudson 

39 Hyde Park 

40 Lawrence 

41 Lee 

42 Leominster 

43 Lexington 

44 Lowell 

45 Ludlow 

46 Lynn 

47 Maiden 

48 Mansfield 

49 Marblehead 

so Marlboro 

51 Maynard 

52 Me'dford 

53 Melrose 

54 Methuen 

55 Milford 

56 Millbury 

57 Milton 

58 Monson 

59 Natick 

60 Needham 



8,609 

558,485 

21,839 

6,028 
66,901 



13.026 
9,894 

5,112 

7,301 

11,187 

8,536 

16,215 

2,013 

4,676 

5,542 

18,650 

670,585 

8,066 

56,878 

27,797 

104,839 

4,797 

5,010 

32,452 

25,401 

13,075 

6,421 

9,407 

9,284 

8,524 

5. 139 

33,484 

19,295 

37.826 

12,948 

5.641 

14,699 

24.398 

5,926 

10,427 

4,965 

57,730 

6,743 

15,507 

85,892 

41,006 

17,580 

4,918 

106,294 

4,948 

89,336 

44,404 

5.183 

7.338 

14,579 

6,390 

23.150 

15.715 

11,448 

15.055 

4.740 

7,927 

4,758 

9,866 

5,026 



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Massachusetts (Con- 
tinued) 

6 1 New Bedford . . . 

62 Newburyport . . . 

63 Newton 

64 Northampton. . . 
6s North Andover . . 

66 North Attleboro . 

67 Northbridge .... 

68 North Brookfield , 

69 Norwood 

70 Orange 

71 Peabody 

72 Pittsfield 

73 Plymouth 

74 Provincetown . . . 

75 Quincy 

76 Randolph 

77 Revere 

78 Rockland 

79 Rockport 

80 Salem 

81 Saugus 

82 Somerville 

83 Southbridge 

84 South Hadley . . . 

85 Spencer 

86 Springfield 

87 Stoneham 

88 Stoughton 

89 Swampscott 

90 Taunton 

91 Turners Falls. . . 

92 Wakefield 

93 Waltham 

94 Ware 

95 Wareham 

96 Watertown 

97 Webster 

98 Westboro . 

99 Westfield 

100 West Springfield . 
loi Weymouth 

102 Whitman 

103 Williamstown . . . 

104 Winchendon . . . . 

105 Winchester 

106 Winthrop 

107 Woburn 

108 Worcester 



Total . 



Michigan 

I Adrian , 

Albion , 

Ann Arbor . . . . , 
Battle Creek . . , 

Bay City 

Benton Harbor. 
Bessemer 

8 Big Rapids 

9 Cadillac 

ID Charlotte 

11 Cheybogan. . . . 

12 Detroit 

13 Dowagaic 

14 Flint 

15 Grand Haven . . 



96,652 

14.949 

39,806 

19,431 

5,529 

9,562 

8,807 

13.075 

8,014 

5,282 

15.721 

32,121 

12,141 

4.369 

32,642 

4.301 

18,219 

6,928 

4,211 

43,697 

8,047 

77.236 

12,592 

4,894 

6,740 

88,926 

7,090 

6,316 

6,204 

34.259 

11,404 

27,834 

8,774 

4,102 

12,875 

11.509 

5,446 

16,044 

9,224 

12,895 

7,292 

3,708 

5,678 

9.309 

10,132 

15.308 

145.986 



10,763 

5.833 

14,817 

25,267 

45.166 

9,185 

4.583 

4.S19 

8,375 

4.886 

6,859 

465,766 

5,088 

38,550 

5.856 



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1904 
1906 
1907 
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1908 
1906 
1908 
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1907 
1909 
1906 

1908 
1908 
1907 
1910 
1908 

1908 

1908 
1906 
1907 
1909 

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1906 
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1906 
1908 



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Michigan (Continued) 

1 6 Grand Rapids 

17 Hillsdale , 

18 Holland 

19 Houghton 

20 Ionia 

21 Iron Mountain. . . . 

22 Ironwood 

23 Jackson 

24 Kalamazoo 

25 Lansing 

26 Ludington 

27 Marshall 

28 Monroe 

29 Mt. Clemens 

30 Muskegon 

31 Negaunee 

32 Norway 

3Z Owosso 

34 Port Huron 

35 Saginaw: 

East Side 
West Side 

36 St. Joseph 

37 Sault Ste. Marie . . . 

38 South Haven 

39 Three Rivers 

40 Traverse City 

41 Wyandotte 

42 Ypsilanti 

Total 

Minnesota 

1 Albert Lea 

2 Anoka 

3 Austin 

4 Duiuth 

5 Ely 

6 Eveleth 

7 Faribault 

8 Fergus Falls 

9 Hastings 

10 Little Falls 

11 Mankato 

12 Minneapolis 

13 Moorhead 

14 New Ulm 

15 Owatona 

16 Red Wing 

17 Rochester 

18 St. Cloud 

19 St. Paul 

20 St. Peter 

21 Stillwater 

22 Virginia 

23 Willmar 

24 Winona 

Total 



112,571 

5,001 

10,490 

5,113 

5,030 

9,216 

12,821 

31,433 

39.437 

31,229 

9,132 

4,236 

6,893 

7,707 

24,062 

8,460 

4,974 

9,639 

18,863 

50,510 



5,936 
12,615 
3,577 
5,072 
12,115 
8,287 
6,230 



6,193 
3,972 
6,960 

78,466 
3,572 
7,036 
9,001 
6,887 
3,983 
6,078 

10,365 
301,408 
4,840 
5.648 
5,658 
9,048 
7,844 

10,600 

214,744 

4,176 

10,198 

10,473 

4.135 

18,583 



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1910 

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1909 

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1907 
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Mississippi 

1 Columbus. . . . 

2 Jackson ...... 

3 Laurel 

4 McComb 

5 Vicksburg .... 

6 Yazoo City . . . 

Total 

Missouri 

1 Aurora 

2 Cape Girardeau 

3 Carthage 

4 Chillicothe ... 

5 Clinton 

6 Columbia 

7 Fulton 

8 Hannibal 

9 Jefferson City . 

10 Joplin 

11 Kansas City. . . 

12 Lexington . . . . , 
' 13 Macon 

14 Marshall 

15 Poplar Bluff. . . 

16 Rich Hill 

17 St. Charles. . . . 

18 St. Joseph. . . . 

19 St. Louis 

20 Sedalia 

2 1 Springfield .... 

22 Trenton 

23 Warrensburg . . 

24 Webb City . . . . 

Total 

Montana 

1 Anaconda 

2 Bozeman 

3 Butte 

4 Great Falls. . . . 

5 Helena 

6 Missoula 

Total 

Nebraska 

1 Beatrice 

2 Fremont 

3 Grand Island . . 

4 Hastings 

5 Kearney 

6 Lincoln 

7 Nebraska City . 

8 Norfolk 

9 North Platte . . , 

10 Plattsmouth. . . 

1 1 South Omaha . . 

12 York 

Total 



21,262 
8,465 
6,237 

20,814 
6,796 



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,483 
,265 
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,662 
,228 

,341 
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,073 
,381 
,242 
.584 
,869 
,916 
,755 
.437 
403 
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,822 
201 
,656 
689 
817 



10,134 
5,107 
39,i6s 
13,948 
12,515 
12,869 



9,356 
8,718 

10,326 
9,338 
6,202 

43,973 
5,488 
6,025 
4,793 
4,287 

26,259 
6.235 



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Nevada 

I Reno 

Total 

New Hampshire 

1 Berlin 

2 Claremont 

3 Concord: 

Union District . . 
Penacook District 

4 Dover 

5 Exeter 

6 Franklin 

7 Keene 

8 Laconia 

9 Manchester 

10 Nashua 

11 Portsmouth 

12 Rochester 

Total 

New Jersey 

1 Asbury Park 

2 Atlantic City 

3 Bayonne 

4 Bloomfield 

5 Bordentown 

6 Bridgeton 

7 Camden 

8 Dover 

9 East Orange 

10 Elizabeth 

1 1 Englewood 

12 Garfield 

13 Gloucester City . . . 

14 Hackensack 

15 Hammonton 

16 Hoboken 

17 Irvington 

18 Jersey City 

19 Kearney 

20 Lambertville 

21 Long Branch 

22 Madison 

23 Montclair 

24 Morristown 

25 Newark 

26 New Brunswick . . . 

27 North Plainfield . . . 

28 Orange 

29 Passaic 

30 Paterson 

31 Perth Amboy 

32 Plainfield 

33 Princeton 

34 Rahway 

35 Red Bank 

36 Rutherford 

37 Salem 

38 Somerville 

39 South Amboy 

40 South Orange 

41 Summit 

42 Town of Union .... 



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10,867 



11,780 
7.529 

21,497 



13,247 

4.897 

6,132 

10,068 

10,183 

70,063 

26,005 

11,269 

8,868 



10,150 

46.150 

55.545 

15.070 

4.250 

14,209 

94.538 

7,468 

34,371 

73,409 

9.924 

10,213 

9.462 

14,050 

5.088 

70,324 

11,877 

267,779 

18,659 

4.657 

13,298 

4-658 

21,550 

12,507 

347,469 

23,388 

6,117 

29,630 

54.773 

125,600 

32,121 

20,550 

5. 136 

9,337 

7.398 

7.045 

6,614 

5.060 

7,007 

6,014 

7.500 

21,023 



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1910 



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909 
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909 
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910 
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910 
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910 
910 
909 
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903 
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902 
909 
902 
900 
908 
898 
909 
909 
909 
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908 
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New Jersey (Continued) 

43 Trenton 

44 Vineland 

45 West New York .... 

46 West Orange 

47 Woodbury 

Total 

New Mexico 

1 Albuquerque 

2 Raton 

3 Santa Fe 

Total 

New York 

1 Albany 

2 Albion 

3 Amsterdam 

4 Auburn 

5 Batavia 

6 Bath 

7 Binghamton 

8 Buffalo 

9 Canandaigua 

ID Catskill 

11 Cohoes 

12 Corning: 

District No. 9 
District No. 13 

13 Cortland 

14 Dansville 

15 Dunkirk 

16 Elmira 

17 Fishkill Landing . . . . 

18 Fredonia 

19 Fulton 

20 Geneva 

21 Haverstraw 

22 Herkimer 

23 Hoosick Falls 

24 Homell 

25 Hudson 

26 Hudson Falls 

27 Ilion 

28 Ithaca 

29 Jamestown 

30 Johnstown 

31 Kingston 

32 Lackawanna 

33 Lancaster 

34 Lansingburg 

35 Lawrence 

36 Lockport 

37 Lyons 

38 Malone 

39 Mamaroneck 

40 Medina 

41 Mt. Vernon 

42 New Rochelle 

43 New York 

44 Niagara Falls 

45 North Tarrytown . . . 

46 North Tonawanda . . 

47 Norwich 

48 Nyack 

49 Olean 



96.815 

5,282 

13,560 

10,980 

4,642 



11,020 
4.539 
5.072 



100 

5 

31 

34 

II 

3 

48 

423, 

7 

5 

24 

13 



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3, 

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10, 

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14, 

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28, 

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30, 

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253 
,016 
,267 
,668 
,613 
,884 
443 
715 
,207 
.293 
.709 
.730 



,507 
,938 
,221 
,176 
,902 
,285 
,480 
,446 
,669 
,520 
,532 
,617 
,417 
,189 
,588 
,802 
,297 
.447 
,908 
,549 
,364 

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,970 
,460 
,467 
,698 
,683 
919 
,867 
,883 
445 
,421 
955 
,422 
.619 
743 



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1900 
1909 
1908 
1903 



1909 
1910 



1908 



1907 
1910 



1910 



1910 



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1909 



1908 

1907 
1910 
1897 






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New York (Continued) 

50 Oneonta 

5 1 Oswego 

52 Owego . . . 

53 Patchogue 

54 Perm Yan 

55 Plattsburg 

56 Port Chester 

57 Port Jervis 

58 Potsdam 

59 Poughkeepsie 

60 Rennselaer 

61 Rochester 

62 Rome 

63 Saratoga Springs . . 

64 Schenectady 

65 Seneca Falls 

66 Solvay 

67 Syracuse 

68 Tarry town 

69 Tonawanda 

70 Troy 

71 Utica 

72 Waterloo 

73 Watertown 

74 Waverly 

75 Wellsville 

76 White Plains 

77 Yonkers 

Total 

North Carolina 

1 Asheville 

2 Concord 

3 Durham 

4 Gastonia 

5 Goldsboro 

6 High Point 

7 Kinston 

8 Mascontah 

9 New Bern 

10 Raleigh 

1 1 Salem 

12 Washington 

13 Wilmington 

14 Wilson 

15 Winston 

Total 

North Dakota 

1 Bismarck 

2 Fargo 

3 Grand Forks 

4 Jamestown 

5 Minot 

6 Valley City 

Total 



o 

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9.491 

23.368 

4.633 

3.824 

4.597 

II. 138 

12,809 

9.314 

4.036 

27.936 

10,711 

218,149 

20,497 

12,693 

72,826 

6,588 

5.139 

137.249 

5.600 

8,290 

76,813 

74.419 

3,931 

26,730 

4.855 

4.382 

15.949 

79,803 



18,762 
8,715 

18,241 
5.759 
6,107 
9.525 
6,995 

9.961 

19,218 

5.533 

6,211 

25.748 

6,717 

17,167 



5.443 
14.331 
12,478 
4.358 
6,188 
4,606 



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H=I2 



197 



160 



E=5 



E = i 



37 



Ohio 

1 Akron 

2 Alliance 

3 Ashland 

4 Ashtabula 

5 Barberton 

6 Bellaire 

7 Bellevue 

8 Bowling Green . . . 

9 Bucyrus 

10 Canton 

11 Chillicothe 

12 Cincinnati 

13 Circleville 

14 Cleveland 

15 Columbus 

16 Conneaut 

17 Coschocton 

18 Dayton 

19 Defiance 

20 Delaware 

21 Delphos 

22 East Liverpool . . . 

23 Elyria 

24 Findlay 

25 Gallon 

26 Gallipolis 

27 Hamilton 

28 Hillsboro 

29 Ironton 

30 Jackson 

31 Kent 

32 Lancaster 

33 Lima 

34 Lorain . 

35 Mansfield 

36 Marietta 

37 Martins Ferry ... . 

38 Massillon 

39 Miamisburg 

40 Middletown 

41 Mt. Vernon 

42 Newark 

43 New Philadelphia . 

44 Niles 

45 North Baltimore . 

46 Norwalk 

47 Norwood 

48 Oberlin 

49 Painesville 

50 Piqua 

51 Portsmouth 

52 Ravenna 

53 St. Marys 

54 Salem 

55 Sandusky 

56 Shelby 

57 Sidney 

58 Springfield 

59 Steubenville 

60 Tiff en 

-61 Toledo 

62 Urbana. 

63 Van Wert 

64 Wapakoneta 

65 Wellston 

66 Xenia 

67 Youngstown 

68 Zanesville 

Total 



69, 

IS, 
6, 

18, 
9, 

12, 
5, 
5, 
8, 

SO, 

14, 

364, 

6, 

560, 

181, 

8, 

9 

116, 

7, 

9 

5 

20 

14 
14 

7 

5 
35 

4 
13 

5 

4 
13 
30 
28 
20 
12 

9 
13 

4 
13 

9 
25 



2 

7 

16 

4 

5 

13 

23 

5 

5 

8 

19 

4 

6 

46 

22 

II 

168 

7 

7 

5 

6 

8 

79 

28 



067 
083 
795 
266 
410 
946 
209 
222 
,122 
217 
,508 
463 

744 
.663 
,548 
319 
,603 
.577 
,327 
,076 
,038 
,387 
,825 
,858 
,214 
,560 
,279 
,296 
,147 
,468 
,488 
,093 
,508 
,883 
,768 
,923 
,133 
,879 
,271 
,152 
087 
,404 
,542 
,361 
,503 
,858 
.185 
,36s 
,501 
.388 
,481 
,310 
,732 
,943 
989 
,903 
,607 
,921 
,391 
,894 
,497 
,739 
,157 
,349 
,875 
,706 
,066 
026 



< 
o o 

<^ 



Pi 
>< 



1909 



1905 
1910 

1906 
1908 



1910 



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go 



1909 



1905 
1909 



1910 



1910 



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67 



24 



38 



Oklahoma 

1 Ardmore 

2 Chickasha. . . . 

3 Durant 

4 El Reno 

5 Guthrie 

6 Lawton 

7 McAlester. . . . 

8 Muskagee .... 

9 Oklahoma City 
ID Perry 

1 1 Ponca 

1 2 Shawnee 

13 Tulsa 

Total 

Oregon 

1 Astoria 

2 Eugene 

3 Pendleton .... 

4 Portland 

5 The Dalles 

Total 

Pennsylvania 

1 Allentown .... 

2 Altoona 

3 Archbald 

4 Athens 

5 Bangor 

6 Beaver Falls . . 

7 Bellefonte .... 

8 Berwick 

9 Bethlehem .... 

10 Blakely 

11 Braddock 

12 Bradford 

13 Bristol 

14 Butler 

15 Carlisle 

i6 Carnegie 

17 Catasauqua. , . 

1 8 Chambersburg 

19 Charleroi 

20 Chester 

21 Clearfield 

22 Coatesville. . . . 

23 Corry 

24 Danville 

25 Darby 

26 Dickson City . 

27 Donora 

28 Dubois 

29 Duryea 

30 Easton 

31 Edwardsdale. . 

32 Erie 

33 Forest City . . . 

34 Franklin 

35 Greensburg . . . 

36 Hanover 

37 Harrisburg. . . . 

38 Hazleton 

39 Homestead ... 

40 Indiana 

41 Jeannette 



8,618 

10,320 

5,330 

7.872 

1 1, 654 
7.788 

12,954 
25.278 
64,205 
3.133 
2,521 
12,474 
18,182 



9.599 
9.009 
4,460 
207,214 
4,880 



51, 

52, 

7, 

3, 

5 

12, 

4. 

5, 
12, 

5, 
19, 
14, 

9, 

20; 
10, 

10 

5, 

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9 

38, 
6, 

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5, 
7, 
6, 
9 
8, 

12, 
7, 

28, 
8 

66 
5, 
9 

13, 
7, 

64, 

25, 

18, 
5, 
8, 



913 
127 

194 
796 
369 
191 
145 
689 
837 
345 
357 
544 
256 
728 
303 
009 
250 
800 
615 
537 
851 
084 
991 
517 
305 
331 
174 
623 

487 
523 
407 
525 
749 
767 
012 
057 
186 
452 
713 

749 
077 



Q O 

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1909 



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1908 

I9IO 

1909 
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1907 



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39 



Pennsylvania (Con- 
tinued) 

42 Jersey Shore 

43 Johnsonburg 

44 Johnstown 

45 Lancaster 

46 Lebanon 

47 Lehighton 

48 McKeesport 

49 McKees Rocks . . . 

50 Mahanoy City . . . 

51 Mauch Chunk . . . 

52 Milton 

53 Monongahela City 

54 Mt. Carmel 

55 Nanticoke 

56 New Brighton . . . . 

57 New Castle 

58 Norristown 

59 Northampton. . . . 

60 North Braddock . . 

61 Philadelphia 

62 Phoenixville 

63 Pitcaim 

64 Pittsburg 

6s Pottstown . 

66 Pottsville 

67 Punxsutawney . . . 

68 Rankin 

69 Reading 

70 Renovo 

71 Ridgeway 

72 St. Clair 

73 St. Marys 

74 Sayre 

75 Scranton 

76 Sewickley 

77 Shamokin 

78 Sharpsburg 

79 Shenandoah 

80 Slatington 

81 South Bethlehem. 

82 South Sharon . . . . 

83 Sunbury 

84 Tamaqua 

85 Tarentum 

86 Titusville 

87 Towanda 

88 Tyrone 

89 Uniontown 

90 Warren 

91 Washington 

92 Waynesboro 

93 West Chester . . . . 

94 West Pittston . . . . 

95 Wilkes Barre . . . . . 

96 Wilkinsburg 

97 Williamsport 

98 Wilmerding 

99 Windber 

100 York 

Total 



5,381 

4.334 

55,482 

47,227 

19.240 

S,3i6 

42,694 

14,702 

15,936 

3.952 

7.460 

7,598 

17,532 

18,877 

8,329 

36,280 

27,875 

8,729 

11,824 

1,549,008 

10,743 

4.979 

533.905 

15.599 

20,236 

9.058 

6,042 

96,071 

4,621 

5. 408 

5.640 

6,346 

6.426 

129,867 

4,479 

19,588 

8,153 

25,774 

4,454 

19.973 

10,190 

13.770 

9,462 

7,414 

8,533 

4,281 

7,176 

13,344 
11,080 
18,778 

7.199 
11,767 

6,848 
67,105 
18,924 
31,860 

6,133 

8,013 
44.750 



Q O 






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1909 
1907 

1909 



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1910 
1904 



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1909 
1908 



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40 



Rhode Island 

1 Bristol 

2 Burrillville 

3 Central Falls 

4 Coventry 

5 Cranston 

6 Cumberland . . . . 

7 East Providence . 

8 Lincoln 

9 Newport 

10 North Kingston . 

1 1 Pawtucket 

12 Providence 

13 South Kingston . 

14 Warwick 

15 Westerly 

16 Woonsocket 

Total 

South Carolina 

1 Abbeville 

2 Anderson 

3 Chester 

4 Columbia 

5 Georgetown 

6 Greenville 

7 Hartsville 

8 Rock Hill 

9 Spartanburg .... 

10 Sumter 

1 1 Union 

Total 

South Dakota 

1 Aberdeen 

2 Deadwood 

3 Lead 

4 Mitchell 

5 Sioux Falls 

6 Yankton 

Total 

Tennessee 

1 Chattanooga . . . . 

2 Clarksville 

3 Jackson 

4 Knoxville 

5 Memphis 

6 Nashville 

Total 



8,565 

7,878 
22,754 

5,848 
21,171 
10,107 
15,808 

9,825 
27,149 

4,048 

51,622 

224,326 

5,176 
26,629 

8,696 
38,125 



4.459 
9,6S4 
4.754 

26,319 
5,530 

15,741 
2,365 
7,216 

17,517 
8,109 
S.623 



10,753 
3,653 
8,392 
6,515 

14.094 
3,787 



44,604 

8,548 

15,779 

36,346 

131.105 

110,364 



Q 

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41 



Texas 

1 Austin 

2 Beaumont . , . . 

3 Belton 

4 Brownsville . . , 

5 Brownwood . . . 

6 Cleburne .... 

7 Corpus Christi 

8 Corsicana 

9 Dallas 

10 Denison 

1 1 Denton 

12 El Paso 

13 Ft. Worth . . . . 

14 Gainesville . . . . 

15 Galveston . . . . 

16 Gonzales 

17 Greenville. . . . 

18 Hillsboro 

19 Houston 

20 Marlin 

21 Marshall 

22 Orange 

23 Palestine 

24 Paris 

25 San Antonio . . 

26 Taylor 

27 Temple 

28 Terrell 

29 Texarkana . . . . 

30 Victoria 

31 Waco 

Total 

Utah 

1 Logan 

2 Park City . . . . 

3 Provo 

4 Salt Lake City 

Total 

Vermont 

1 Barre 

2 Bellows Falls. , 

3 Brattleboro . . , 

4 Montpelier. . . 

5 Rutland 

6 St, Albans . . . . 

7 St. Johnsbury . 

Total 



0\ 

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g 

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o 



29,860 
20,640 

4.164 
10,517 

6,967 
10,364 

8,222 

9,749 

92,104 

13.632 

4.732 

39,279 

73,312 

7,624 

36,091 

3,139 

8,8S0 

6,115 

78,800 

3,878 

11,452 

5.527 

10,482 

11,269 

96,614 

5.314 

10,993 

7,050 

9,790 

3,673 

26,425 



7,522 

3,439 

8,925 

92,777 



10,724 
4,883 
6,517 
7,856 

13,546 
6,381 
8,098 



Q O 
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1909 



1902 
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1907 
1908 
1907 



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42 



Virginia 

1 Alexandria . . . . 

2 Bristol 

3 Charlotteville . 

4 Danville 

5 Fredericksburg 

6 Lynchburg. . . . 

7 Newport News 

8 Norfolk 

9 Portsmouth . . . 

10 Radford 

1 1 Richmond . . . . 

12 Staunton 

13 Suffolk 

Total i 

Washington 

1 Aberdeen 

2 Bellingham . . . 

3 Everett 

4 North Yakima 

5 Olympia 

6 Seattle 

7 Spokane 

8 Tacoma 

9 Vancouver . . . . 
10 Walla Walla . . 

Total 

West Virginia 

1 Bluefield 

2 Charleston . . . . 

3 Clarkesburg. . . 

4 Fairmont 

5 Grafton 

6 Huntington. . . 

7 Martinsburg. . 

8 Moundsville. . 

9 Parkersburg . . 
10 Wheeling 

Total 



15.329 
6,247 
6,76s 

19,020 
5.874 

29,494 

20,205 
67,452 
33.190 

4,202 

127,628 

10,604 

7,008 



i3>66o 
24,298 
24,814 
14,082 
6,996 

237,194 
104,402 

82,972 
9.300 

19.304 



11,188 

22,996 

9.201 

9.711 

7.563 

31,161 

10,698 

8,918 

17,842 

41,641 



< 

U 

Is f 



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1909 



1908 



1905 
1910 



1909 

1910 
1909 
1908 
1907 
1909 
1909 



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H 
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43 



"Wisconsin 



Antigo 

Appleton 

Ashland 

Baraboo 

Beaver Dam .... 

Beloit 

Berlin 

Chippewa Falls. . 
9 De Pere: 

East Side 

West Side 

10 Fond du Lac .... 

11 Grand Rapids. . . 

12 Green Bay 

13 Janesville 

14 Kaukauna 

15 Kenosha 

16 La Crosse 

17 Madison 

18 Manitowac 

19 Marinette 

20 Marshfield 

21 Menasha 

22 Menominee 

23 Merrill 

54 Milwaukee 

25 Monroe 

26 Neenah 

27 Oconto 

28 Oshkosh 

29 Platteville 

30 Portage 

3 1 Racine , 

32 Rhinelander .... 

33 Sheboygan 

34 South Milwaukee , 

35 Stoughton 

36 Superior 

37 Two Rivers 

38 Washburn 

39 Watertown 

40 Waukesha 

41 Wausau 



Total , 



Wyoming 

1 Cheyenne. . . . 

2 Rock Springs 

3 Sheridan .... 



Total , 



7,196 

16.773 

11,594 

6,324 

6,758 

15,125 

4.636 

8,893 

4.477 



18,997 

6,521 

25.236 

13.894 

21,371 

21,371 

30,417 

25,531 

13,027 

14,610 

5,783 

6,081 

5.036 

8,689 

373,857 

4.410 

5.734 

S.629 

33.062 

4.452 

5,440 

38,002 

5,637 

26,398 

6,092 

4.761 

40,384 

4.850 

3,830 

8,829 

8,740 

16,560 



11,320 
5.778 
8,408 



< 

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1909 



1910 



1910 

1908 
1909 
1909 



1910 
1909 



1910 



1910 
1908 
1910 



1910 



1910 



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37 



Some Publications of the Department of Child 
Hygiene, Russell Sage Foundation 

400 Metropolitan Tower, New York City 



Medical Inspection 

No. 54. The Argument for Medical Inspection and Some Signi- 
ficant Facts 

Hygiene and Health 

No. 71. Open Air Schools. Leonard P. Ayres, Ph.D. 
No. 99. Medical Inspection Legislation. (Price 20 cents.) Com- 
piled by Leonard P. Ayres, Ph.D. 



Medical Inspection of Schools. — Luther H. Gulick, M.D., and Leonard 
P. Ayres, Ph.D. 276 pages. Price, postpaid, $1.00. Charities Pub- 
lication Committee, 105 East 22d Street, New York City. 

Gives in convenient form information about the historical, educa- 
tional, administrative, and legal phases of the work. The most extensive 
bibliography on the subject yet compiled is added. This book has run 
into three editions. 

Open Air Schools. — Leonard P. Ayres, Ph.D. 171 pages. Price $1.20 
(postage 12 cents). Doubleday, Page & Co., New York. 

This volume gives the important and significant American and 
foreign material with respect to outdoor schools. It describes the Eng- 
lish, German and American types, gives the results and furnishes de- 
finite information with respect to clothing, food, cost, administration, 
etc. It has more than 70 pages of illustrations and diagrams. Biblio- 
graphy. 



A leaflet giving full list of printed matter will he mailed on request. 



LIBRARY OF CONGRESS 







020 313 Hi Q 




